Botox Injections – What You Need To Know

In the past few years, Botox injections have become one of the most popular methods for reversing the signs of aging. They can be used to reduce the appearance of expression lines, fine lines, wrinkles and to give the face an overall younger looking appearance.

Not surprisingly, many TV personalities, actors and models use Botox to keep them looking young for as long as possible, which is partly why this non surgical anti-aging treatment has received such widespread acceptance amongst members of the general public who also hope to obtain similar results.

In addition to its cosmetic uses, Botox can also be used for non cosmetic purposes. It can for example, be injected in the armpits to reduce excessive sweating (hyperhidrosis), injected near the eyes to control involuntary twitching of the eyelids (blepharospasm) or even injected in the neck to reduce muscle spasms (cervical dystonia) or neck pain.

Other uses include migraine relief, treating overactive bladders, straightening crossed eyes (strabismus) and controlling facial spasms. So as you can see, Botox truly is a remarkable treatment that can help a person to look, live and feel better all without having surgery.

What Is Botox?

Botox is an abbreviated name for botulism toxin and consists of a purified protein from a toxin produced by the Clostridium botulinum bacteria.

When injected underneath the skin, it paralyzes muscles in the treated area by blocking the activity of the acetylcholine neurotransmitter which the body uses to create voluntary muscle contractions. The effect of this is a firming and tightening of the skin which subsequently reduces the visibility of any lines and wrinkles in that localized area.

These effects are however, only temporary, as in three to four months the body will break down the botulism toxin protein and the previously paralyzed muscles will start to regain their normal function. When this occurs, the skin will lose its firmness and tightness and your lines and wrinkles will become more visible again.

Note: In most people Botox will last for an average of three months.

In order to maintain your results, it is therefore necessary to have repeat treatments and so most people will have 3-4 treatments done each year. Botox administered over an extended period of time however, such as over a 12-18 month period, may result in the facial muscles become weak, or atrophied, due to a lack of use, even in the absence of the botulism toxin protein.

As a result, some people notice that even when they stop having Botox injections, their wrinkles appear much less prominent than they once were. Unfortunately, this after effect is only a temporary one, because eventually, the muscles in the face will regain their strength and your wrinkles will start to become more noticeable again.

Where Can Botox Be Used?

When used as a cosmetic treatment, the most common site of application for Botox is on the face. For example, it can be applied to the forehead to fade creases caused as a result of raising the eyebrows (worry lines), between the eyebrows to fade frown lines (glabellar lines) and at the outer corners of the eyes to lessen the appearance of crow’s feet (periorbital lines).

Botox may also be injected around the mouth area such in the upper and lower lips to treat wrinkles caused by smoking, in the chin, in the nasolabial folds (laugh lines) and in marionette lines. However, if you are trying to treat very deep creases or folds in the face, then you may find the use of a dermal filler such as collagen, Restylane, Sculptra or Radiesse to be more effective at treating your problem areas.

Below is shown a picture that displays the Botox injection sites for the upper portion of the face. It is important to note that when Botox is injected in the skin it must be done so precisely, as injecting the wrong region can result in the wrong muscles being paralyzed which could then give your face a grossly distorted abnormal looking appearance.

In the hands of an experienced dermatologist, plastic surgeon or cosmetic doctor, Botox can also be skillfully administered in the forehead to create a chemical brow lift.

This is achieved by injecting Botox into certain muscles of the forehead so that they pull the eyebrows upwards and stop them from drooping or sagging downwards. The effect can be quite dramatic, as it gives the upper region of the face a more youthful, alert and refreshed appearance similar to what you would get from a surgical face lift.

Great care must be taken when trying to achieve this type of effect however, as applying Botox too low on the forehead can result in the eyelids or eyebrows being raised too much. Although this can look strange, thankfully the effects are only temporary and normal appearance will be restored in a few months as the Botox injection wears off.

Procedure

A typical Botox treatment session can last anywhere from 10-30 minutes depending on the area that needs to be treated. Full results of your treatment will usually take 3-7 days to show.

If, after this time, you feel as though you have too much muscle movement or that you didn’t get the results you were hoping for, you should return back to your dermatologist, plastic surgeon or cosmetic doctor and ask for an additional shot. Most of the time, you will be able to get this done for free or at a reduced rate.

The procedure itself first begins with an assessment of your face and the problem areas that you would like to address. During this assessment you will be asked to deliberately wrinkle your face such as by lifting your eyebrows, scowling and smiling.

This is by far the most important step of the whole procedure, because as was previously mentioned, an incorrectly administered Botox injection can easily result in the wrong facial muscles being paralyzed and an irregular unnatural looking appearance. So it is vital that the person giving you your injection has a detailed understanding of the muscular system of the face and knows where to inject Botox in order to give you the result that you desire.

Once the assessment of your face has been completed and the target muscles identified, your face will be lightly cleansed with a mild disinfectant/antiseptic so as to minimize the risk of infection once the protective barrier of the skin has been broken.

Botox (Botulinum toxin type A) is then injected underneath the skin, in the target areas, with a micro needle so that the injection wounds will heal quickly and there will be no visible scarring left behind. You may sometimes see Botox being advertised as a “painless procedure” or as a procedure with “minimal discomfort”, unfortunately, this isn’t true for everyone.

Botox is generally administered without the use of a topical anesthetic or numbing creaming, and as a result, you will be able to feel the needle going into your skin. A numbing cream can be used however, as shown in the video above, which should greatly reduce the amount of pain that you experience.

How painful you will find Botox largely depends on where in the face you are having it administered and your previous experience with facial injections. Injections around the eye area and lips tend to be the most painful, whereas those on the forehead and between the eyebrows tend to be less painful as the skin is thicker and less sensitive in those areas.

Different people may however, find different areas of the face to be more painful than others as the overall sensitivity of the skin on your face can be influenced by your genetic skin type. A person with sensitive skin for example, may find Botox injections to be more painful than a person who has an oily skin type because their skin tends to be thinner.

If you have previously had dermal filler injections before, then you probably won’t find Botox injections too uncomfortable, although they will still result in some amount of pain and certainly won’t be pain free. Of course, the more facial injections you have, the more you will get used to the discomfort, so after 3-4 treatments you should be able to tolerate the injections quite well.

To give you an idea of the kind of result that you can expect from a typical treatment, have a look at the following before and after Botox video.

Maintaining A Natural Look

Whilst Botox can certainly help to make your face look younger, firmer and more wrinkle free, it is important that your face still retains a natural look. There is nothing worse than getting too much Botox and then having no expression on your face for the next few months.

Botox should therefore be used to address problems areas of your face, but should still leave you able to express yourself through your face. If you are not able to do this, you can appear dull, boring and uninteresting to others.

Furthermore, because the use of Botox is quite widespread and many people are aware of the results that it can produce, an expressionless face is now seen as a tell-tale sign that you have had Botox injections. So if you want to improve the appearance of your face discretely, without making it obvious that you have had Botox, then it is important that you retain the ability to form facial expressions to some degree.

Of course, due to the nature of Botox, your ability to make facial expressions will be somewhat impaired, so this is something that you can’t avoid entirely. An experienced administer of Botox will know how to make this trade-off by giving you the results you desire, but at the same time still allowing you to move your face normally.

If you find that you are requiring increasingly more Botox injections across your face, then you may want to consider a surgical face lift instead as this will give you better and longer lasting results.

Post Treatment Botox Skin Care

After your Botox treatment, you won’t be able to lie down for four hours or massage the treated muscles. If you do this, Botox could be spread to other regions of the face and produce abnormal looking results, this is known as Botox migration and is especially a concern if you have received treatment around the eye area.

After your treatment, it is recommended to exercise the injected muscles every 15 minutes for a period of one to four hours. This can be done by doing face exercises to contract and relax your muscles after your Botox injection. These exercises should be done without touching your face, as treated areas should not be rubbed until 12 hours after your treatment.

The reason it is important to exercise your face muscles after a Botox injection, is because the Botox toxin protein attaches itself best to muscle nerves which are active or being used. So the better the Botox is allowed to work, the greater of a reduction you will notice in your wrinkles and the firmer your skin will become.

Your injection wounds should heal up fairly rapidly, although until they do, which usually takes less than a day, you should not touch your face with your hands unless they have been washed. You may also be advised to disinfect the treated areas to minimize the risk of an infection occurring after your procedure has been completed.

If you notice swelling, bruising or redness in the treated areas, then applying ice may help to alleviate your symptoms somewhat. This ice should not be applied directly to the naked skin, but first wrapped in a towel or thick kitchen tissue. If your redness persists and you need to go to work, then the use of a light foundation or concealer can help to cover up your skin until it returns back to normal.

Overall though, recovery from Botox injections tends to occur quite rapidly and downtime is minimal. You will be able to return back to work the same day and carry on with your normal activities without too much interference.

Acceptance Requirements

Botox injections can be administered to both men and women aged between 18-65, although the most common age groups for this treatment are people who are in their 30s, 40s and 50s.

Most people who are in good health and are not taking any medications should have no problems being accepted for Botox injections, there are however, some cases where an individual may be declined treatment such as those listed below.

Pregnancy

Pregnant women are generally advised not to get Botox injections just in case there are any adverse effects caused to the developing fetus. The same recommendations are extended to breastfeeding women.

Infections

Those with skin infections on the face or with active acne outbreaks may be refused treatment as the infection could affect the eventual results obtained.

Medications

Quinidine, polymyxin and aminoglycoside based medications may cause adverse reactions in the presence of Botox. If you are taking any type of pharmaceutical medication, you should inform your surgeon of them beforehand for your own safety.

Allergies

Some people are allergic to albumin or the Botulinum toxin protein. There is however, no requirement for a skin test to be done before Botox is administered.

Illness

Certain neurological disorders such as Amyotrophic Lateral Sclerosis (ALS) or autoimmune disorders such as Myasthenia gravis may disqualify a person from receiving Botox injections.

Antibiotics

Botox may cause an adverse reaction when a person is taking antibiotic medication such as Gentamicin or Clindamycin.

Blood Thinning Medications

Individuals taking blood thinning medications such as aspirin, heparin or warfarin will usually be advised to cease taking their medication for a few weeks prior to their procedure. This is a precautionary measure as blood thinning medication may result in increased bruising of the treated areas. If one is unable to stop taking their medication, they may, in some cases, be refused treatment.

Risks / Side Effects / Complications

Botox is an FDA approved treatment, but as with any type of injection, especially a facial injection, there is a risk of swelling, bruising an inflammation in the treated area. This can leave your face looking red and feeling tender for a few days, although in the large majority of people, this should completely subside within a week.

If you find yourself in an uncomfortable level of pain after your Botox injection, you can try taking an over the counter painkiller such as a paracetamol to alleviate your pain. If your pain continues to persist, then you should seek medical attention as it could be an indication of something more serious.

When Botox is applied to the skin surrounding the eyes, the risk of suffering from a side effect tends to be higher due to the delicate skin of the eyes and the eyes themselves. One such side effect is drooping of the eyebrows or eyelids which can last three to six months, or until the Botox toxin protein wears off.

More seriously, a Botox injection could potentially cause double vision in a patient which could then severely impact their ability to function normally and carry out everyday activities. Fortunately though, this tends to be quite a rare occurrence. Another delicate area of the face are the lips, and there is a risk of the lips becoming immobilized should Botox be incorrectly administered which could then affect a person’s ability to speak clearly.

Other possible side effects of Botox include nausea, facial discomfort, facial tightness, flu-like symptoms, allergic reactions which make breathing difficult, dental problems, dryness of the mouth, soreness of the throat and headaches. Most of these symptoms will only last for 24-48 hours at most.

At present, there are no known long-term side effects that come from Botox injections. There are however, emerging concerns that Botox may cause new wrinkles to appear on the face and that Botox itself may be addictive especially if it is started at a young age.

The most serious complications of Botox occur if the botulism toxin protein spreads to other regions of the body or enters the bloodstream. In such cases, a person may require hospitalization as their condition could be life threatening.

The risk of this happening though, is very low, as Botox is almost immediately absorbed into the injected area and the amount that you are being injected with is a very small amount. Most serious complications occur as a result of using illegal forms of Botox administered by a non medical professional.

Like all medical or cosmetic procedures, the risk of suffering from a complication can be greatly reduced by having your Botox administered by a board certified physician, cosmetic plastic surgeon or cosmetic dermatologist.

The procedure itself should also be carried out in a suitable medical environment, such as in a hospital, doctor’s surgery or medical spa, where medical professionals can operate in a clean and hygienic environment.

One should avoid receiving Botox in a non medical environment, such as at home as part of a Botox party, as this can greatly increase the risk of the wrong muscles being treated and thus the risk of a bad looking end result.

Cost

How much Botox injections cost depends on who you go to and the area that needs to be treated. In general though, you can expect prices to range from $250 to $500 for the treatment of one area, $300 to $600 for the treatment of two areas and $400 to $800 for the treatment of three areas. Prices do however, vary, and a single vial of Botox can cost up to $1000 in some cases.

Prices are charged based on the amount of units that are used. A single unit usually costs $10 to $20 with 20-30 units being needed per area on average. It is possible to get Botox done at reduced cost, but this usually comes at the expense of a less qualified administrator, lower standards of hygiene and the possibility of receiving fake Botox.

Obviously, this is not a very worthwhile price to pay, as it may leave your face looking unnatural and increase your risk of infection. So if you want to have Botox done, then it is worth paying the going rate to ensure that you get it done properly and don’t suffer from any undesirable complications.

If you are in to risk taking however, you may be able to get a Botox injection done for free or at nominal cost. Some Botox training centers for example, require patients to practice on and will advertise for volunteers. This could save you a lot of money if you regularly get Botox injections, but it could also greatly increase the risk of something going wrong.

Finally, as Botox injections are usually an elective non-surgical procedure carried out for cosmetic reasons, most insurers will not cover the cost of the procedure.

If you are having Botox injections for non cosmetic purposes however, such as to stop excessive sweating, correct a lazy eye or stop involuntary muscle twitching, then you may qualify under a medical insurance policy that will pay for the cost of your treatments. As a general rule though, Botox done purely for cosmetic purposes will not be covered by health insurance.